CHA has submitted the attached comments to the Centers for Medicare & Medicaid Services (CMS). The comments address the CMS notice implementing a framework for measures and methodology for the health insurance exchange quality reporting system (QRS), as required by the Affordable Care Act. In the comment letter, CHA supports a phased-in approach to implementation of a QRS and urges CMS to continually evaluate and refine the framework, measures and timing of the rollout as the patient population evolves. CHA also urges CMS to remain actively engaged with the Measures Applications Partnership (MAP) health insurance exchange task force. CHA’s detailed comments provide a number of specific recommendations regarding the QRS goals and principles, measure selection, and organization and hierarchical structure. CHA will continue to work closely with Covered California and CMS in the implementation and evaluation of a QRS.